Individual
RYAN LOGUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
5462 TILTED STONE, COLUMBIA, MD 21045-2430
(240) 481-5164
Mailing address
5462 TILTED STONE, COLUMBIA, MD 21045-2430
(240) 481-5164
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC5991
MD
Other
Enumeration date
05/06/2016
Last updated
05/06/2016
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